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Medicare/CMS
Medicare Advantage Appeals
Medicare/CMS Forms & Resources
Monday, 31 January 2011

While Medicare Advantage (also known as Part C) plans are NOT regulated or governed by ERISA, there are similar appeal protections.  CMS governs and monitors MA plans, and sets the policies that MA plans must follow. MA plans have contracts with CMS to provide insurance to beneficiaries and CMS pays MA plans to provide those services.   Therefore, the appeals process for MA plans is dictated by CMS. 

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Medicare Reminder: Important Information on the Timely Claims Filing Requirement
Medicare/CMS News
Tuesday, 21 December 2010
Medicare Timely Claims Filing Reduced to 12 Months.
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Comparative Billing Reports (CBR) - How you are doing compared to Florida and national statistics?
Medicare/CMS Forms & Resources
Wednesday, 24 November 2010

Many chiropractors are receiving a report from Medicare that tells them how they compare to their state and national colleagues.

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Medicare Electronic Billing Mandated Changes
Medicare/CMS News
Wednesday, 10 November 2010
There are changes coming regarding electronic billing that will eventually affect all providers serving Medicare patients. The second page of the notice explains what questions to ask your billing vendor. 
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EHR Incentive Program: Certified Health IT Product List
Medicare/CMS News
Monday, 01 November 2010
Providers must use certified Electronic Health Record (EHR) technology in order to earn incentives under the Medicare and Medicaid EHR Incentive Programs.  How can you be sure which EHR technology has been certified?
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Medicare Enrollment Fact Sheets
Medicare/CMS Forms & Resources
Monday, 04 October 2010

New Enrollment Fact Sheets from the Medicare Learning Network.

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Medicare Secondary Payers
Medicare/CMS News
Friday, 01 October 2010
From the Medicare Learning Network: “Medicare Secondary Payer (MSP) Fact Sheet, for Provider, Physician, and Other Supplier Billing Staff”
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Updates from the Medicare Learning Network
Medicare/CMS Forms & Resources
Wednesday, 15 September 2010

Following are several updates from the Medicare Learning Network, which include downloadable resources, to help you better navigate your way through Medicare claims.

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Medicare Audit Alert!
Medicare/CMS News
Thursday, 02 September 2010
            You may be subject to an on-going Medicare audit and not realize it. If you fail to respond to a medical records request letter from “CERT DC” within the specified time period of 30 days, your claims under review will be denied and may result in fraud referral.
            Be prepared. Promptly review all mail received from Medicare, CMS, First Coast Service Options or especially CERT DC. Go back through mail beginning in August for any missed letters.
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Just Released: Medicare to Audit Chiropractic claims
Medicare/CMS News
Monday, 16 August 2010
            Medicare is launching a CERT audit focused on chiropractors based on the results of a 2009 audit by the Office of Inspector General (OIG).
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